an inestimable benefit. An hysterical girl is, as Wendell Holmes has
said in his decisive phrase, a vampire who sucks the blood of the
healthy people about her; and I may add that pretty surely where there
is one hysterical girl there will be soon or late two sick women. If
circumstances oblige us to treat such a person in her own home, let us
at least change her room, and also have it well understood how far we
are to control her surroundings and to govern as to visitors and the
company of her own family. Do as we may, we shall always lessen thus our
chances of success, but we shall certainly not altogether destroy them.

I should add here a few words of caution as to the time of year best
fitted for treatment. In the summer seclusion is often undesirable when
the patient is well enough to gain help by change of air; moreover, at
this season massage is less agreeable than in winter, and, as a rule, I
find it harder to feed and to fatten persons at rest during our summer
heats. That this rule is not without exception has been shown by Drs.
Goodell and Sinkler, both of whom have attained some remarkable
successes in midsummer.

One of the questions of most importance in the carrying out of this
treatment is the choice of a nurse. Just as it is desirable to change
the home of the patient, her diet, her atmosphere, so also is it well,
for the mere alterative value of such change, to surround her with
strangers and to put aside any nurse with whom she may have grown
familiar. As I have sometimes succeeded in treating invalids in their
own homes, so have I occasionally been able to carry through cases
nursed by a mother, or sister, or friend of exceptional firmness; but to
attempt this is to be heavily handicapped, and the position should never
be accepted if it be possible to make other arrangements. Any firm,
intelligent woman of tact, a stranger to the patient, is better than